QuestionI am 35 y/o, female, moderately physically active. An xray taken 2 years ago showed degenerative disk disease at C4-C5. Then recently one of my lower cervical vertebrae became rotated a few degrees to the right (I don't know when or how it happened). It and one vertebra above it visibly bulge out. In the past 6 months I developed chronic muscle fatigue, burning & tingling/crawling feeling along the neck, shoulder, scapula, and spine on the right side from the rotated vertebra downward, with pain and weakness extending into right arm. I saw a chiropractor 1-2 times a week for the problem (he always performs manipulation/cracks the neck & back). There was no improvement in symptoms even after the adjustments. So for the last 4 weeks I've seen a physical therapist 2x week. The therapist has me do exercises and also gently mobilizes the neck without cracking it. My symptoms have not improved significantly.
Yesterday, as before, the phys therapist had me lying face up on the table, cradled my neck from underneath then applied firm pressure with fingers to various places on neck & at base of skull. When he did so I felt pressure in my temples & toward the center of forehead like a shadow of a headache. (I rarely ever get headaches.) The pressure went away once he removed fingers from the base of skull. Immediately after I got up from the table I felt as if my left ear were stuffed, with a feeling of pressure inside, decreased hearing, and low level ringing. It's been over 24 hours & the ear symptoms haven't changed.
Two questions:
1. If it is possible to rotate the vertebra back into alignment with the others, what's the best way to do so?
2. How do I reverse the symptoms of clogged ear / hearing loss /ringing?
AnswerHi Juliska,
1: There is no such thing a vertebra that rotates out of place. What we see on an x-ray and think is misaligned is just variations on your anatomy. It's not like one day your vertebra was straight and then it suddenly went out of alignment. The degenerative changes seen on the x-ray also poorly correlate with symptoms. Lots of people have degenerative changes in their spine and feel fine, and others have perfect x-rays and are in miserable pain, so you can't always be sure that's the problem. You don't know at all what your disc is doing based on x-ray. You can only see it on MRI. And even on MRI, you have to be careful about making assumptions about what is causing the pain. Therefore, attempting to realign something that is not misaligned in the first place might simply be causing a repetitive strain to the joint. A more modern paradigm is doing the adjustment to joints that are stiff, stuck, or lack normal movement. These, too, are often tender joints. Lastly, if the provider is not doing some kind of skilled soft tissue work around your neck, then only have the battle is won on getting your symptoms gone. For example, look at: www.faktr.com. Even simple massage in combination with joint manipulation can make a difference compared to joint manipulation alone (and visa versa). At best, try therapeutic ultrasound, then soft tissue massage, and then manipulation - then exercise!
2: The therapist irritated a muscle in your neck and it refers symptoms to the ear. Just like some muscles refer pain to your temples when they are squeezed or pressed. Go to Google-images and type in "sternocleidomastoid stretch" and you will see images that highlight the muscle, how to stretch it, and also images of the referred pain patterns from it, one of which goes to the ear canal. Get into the stretch position, then rub the muscle up and down with an ice cube while you stretch. Hold the stretch for about 15 seconds while rubbing/massaging with the ice cube (or freeze a small paper cup of water and pop it out of cup on to dry towel). Do a few "ice and stretch" rep's and see if it goes away. Maybe have someone "ice and stretch" your neck and upper back muscles, then massage them, and then exercise them (see my web site for the neck/shoulder theraband exercise).
'Hope this helps.
Dr. G
